血栓弹力图(TEG)在危重颅脑损伤行血肿清除术患者血液净化中的应用价值  

The Application Value of Thrombus Elasticity Chart (TEG) in the Blood Purification of Patients Undergoing Hematoma Removal in Critical Brain Injury

作　　者：亓永杰[1] 杨兴菊[1] 段崇浩[1] 李学军[1] 杨逢永[1] 魏光晨[1] QI Yong-jie;YANG Xing-ju;DUAN Chong-hao;LI Xue-jun;YAN Feng-yonh;WEI Guang-chen(ICU of Taishan Medical College Affiliated To Laiwu People＇s Hospital,Laiwu,Shandong,271100)

机构地区：[1]泰山医学院附属莱芜市人民医院ICU,山东莱芜271100

出　　处：《智慧健康》2018年第27期11-12,共2页Smart Healthcare

摘　　要：目的探讨血栓弹力图(TEG)在危重症颅脑损伤行血肿清除术患者围手术期中的应用价值,为以后的临床诊治提供一定的参考价值。方法回顾性分析2015年12月至2017年1月收治的74例需要行开颅血肿清除术的危重症颅脑损伤患者,随机分为血栓弹力图(TEG)组和对照组,每组各37例患者。TEG组测量凝固角(α值)、反应时间(R值)、血栓最大幅度(Ma值)和凝血形成时间(K值)等项参数,根据测量结果给患者输注血液制品。对照组则根据患者的出血量及血气分析结果,以临床经验疗法进行围手术期管理。两组患者治疗前后比较血液净化程度。结果两组患者的手术时间无显著差异(P>0.05);TEG组的出血量以及冷沉淀、红细胞、血小板输注量、新鲜血浆与对照组相比,明显减少(P<0.05)。手术后TEG组患者的血液净化情况稍优于对照组患者,但差异无统计学意义(P>0.05)。结论 TEG可监测患者的凝血功能,指导患者的输血,合理控制血液制品的输注量,并一定程度上指导血液净化,在重型颅脑损伤患者围手术期中意义重大。Objective to explore the application value of thrombolytic elasticity chart（TEG） in the perioperative period of patients undergoing hematoma clearance for critical craniocerebral injury, and to provide certain reference value for future clinical diagnosis and treatment. Methods retrospective analysis of 74 cases of severe craniocerebral injury patients who were treated by craniotomy from December 2015 to January 2017 were randomly divided into thrombosis Force（TEG） Group and control group, each group of 37 patients. In the TEG group, parameters such as coagulation Angle（α value）, reaction time（R value）, maximum thrombosis（Ma value） and coagulation formation time（K value） were measured, and blood products were given to the patients according to the measured results. In the control group, perioperative management was performed with clinical experiential therapy according to the results of blood loss and blood gas analysis. Blood purification level was compared between the two groups before and after treatment. Results there was no significant difference in operation time between the two groups（P〉0.05）. Blood loss, cold precipitation, red blood cells, platelet transfusion, and fresh plasma were significantly decreased in TEG group compared with the control group（P〈0.05）. Blood purification in TEG group was slightly better than that in control group, but the difference was not statistically significant（P〉0.05）. Conclusion TEG can monitor the coagulation function of patients, guide the blood transfusion of patients, control the infusion volume of blood products reasonably, and guide the blood purification to some extent, which is of great significance in the perioperative period of patients with severe craniocerebral injury.

关 键 词：血栓弹力图 重型颅脑损伤 凝血功能 血液净化 

分 类 号：R651.15[医药卫生—外科学]